This new National Library of Medicine contract follows a $7.25 million NLM award that created the University of Iowa's National Laboratory for the Study of Rural Telemedicine in 1994. Since then, ten Iowa hospitals have been linked to the UI telemedicine research and development network and a number of educational resources and services have been made available to these hospitals. The new grant will fund research in two basic areas: clinical consultations and the use of specialized databases for health care A series of projects will measure the effectiveness of video consultations for patients with special health care needs, including children with disabilities or heart conditions and people with mental illness. Using video conferencing technologies, physicians and patients at networked hospitals will be able to consult with specialists at the UI. Another project builds on previous efforts to offer emergency room support at community hospitals. Special database software and video conferencing will help emergency room staff care for heart attack and stroke patients, again linking rural hospitals with the UIHC to treat serious and time- sensitive problems. The new contract will also fund an innovative project to deliver health information into the homes of people with diabetes. Patients will receive an easy to use device that attaches to their television set and provides access to on-line health information. This project also uses emerging video file server technology to make patient education materials available on demand in a hospital or clinic setting. Researchers hope that providing patients with electronic education and the means to communicate on-line with health care providers can help them manage their disease. In addition to these projects, NLM funding will allow ongoing support for UI's Telemedicine Resource Center which provides coordination and administration of telemedicine services at the UI, and technical support for the remote hospitals.